School of Psychology, University of New South Wales, Sydney, NSW, Australia.
Brain Dynamics Centre, Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia.
Mol Psychiatry. 2023 Sep;28(9):3581-3594. doi: 10.1038/s41380-023-02291-w. Epub 2023 Oct 16.
While the amygdala is often implicated in the neurobiology of posttraumatic stress disorder (PTSD), the pattern of results remains mixed. One reason for this may be the heterogeneity of amygdala subnuclei and their functional connections. This review used PRISMA guidelines to synthesize research exploring the functional connectivity of three primary amygdala subnuclei, basolateral (BLA), centromedial (CMA), and superficial nuclei (SFA), in PTSD (N = 331) relative to trauma-exposed (N = 155) and non-trauma-exposed controls (N = 210). Although studies were limited (N = 11), preliminary evidence suggests that in PTSD compared to trauma-exposed controls, the BLA shows greater connectivity with the dorsal anterior cingulate, an area involved in salience detection. In PTSD compared to non-trauma-exposed controls, the BLA shows greater connectivity with the middle frontal gyrus, an area involved in attention. No other connections were replicated across studies. A secondary aim of this review was to outline the limitations of this field to better shape future research. Importantly, the results from this review indicate the need to consider potential mediators of amygdala subnuclei connectivity, such as trauma type and sex, when conducting such studies. They also highlight the need to be aware of the limited inferences we can make with such small samples that investigate small subcortical structures on low field strength magnetic resonance imaging scanners. Collectively, this review demonstrates the importance of exploring the differential connectivity of amygdala subnuclei to understand the pathophysiology of PTSD and stresses the need for future research to harness the strength of ultra-high field imaging to gain a more sensitive picture of the neural connectivity underlying PTSD.
虽然杏仁核在创伤后应激障碍（PTSD）的神经生物学中经常被涉及，但结果模式仍然存在差异。造成这种情况的一个原因可能是杏仁核亚核及其功能连接的异质性。本综述使用 PRISMA 指南综合了探索三个主要杏仁核亚核（基底外侧核（BLA）、中央内侧核（CMA）和浅层核（SFA））在 PTSD 中的功能连接的研究（N=331），相对于创伤暴露（N=155）和非创伤暴露对照组（N=210）。尽管研究有限（N=11），初步证据表明，与创伤暴露对照组相比，PTSD 中 BLA 与背侧前扣带回的连接更强，背侧前扣带回是一个参与突显检测的区域。与非创伤暴露对照组相比，PTSD 中 BLA 与中额回的连接更强，中额回是一个参与注意力的区域。没有其他连接在研究中得到复制。本综述的第二个目的是概述该领域的局限性，以更好地规划未来的研究。重要的是，该综述的结果表明，在进行此类研究时，需要考虑杏仁核亚核连接的潜在介质，例如创伤类型和性别。它们还强调了需要意识到我们可以从这种研究小样本中得出的有限推断，这些研究调查了低场强磁共振成像扫描仪上的小皮质下结构。总的来说，本综述表明探索杏仁核亚核的差异连接对于理解 PTSD 的病理生理学非常重要，并强调需要未来的研究利用超高场成像的优势，更敏感地描绘 PTSD 下的神经连接。
